Penoscrotal Hypospadias Repair

1. Surgical Approach

2. Incision

3. Insert Catheter

4. Dissection

1. Island Flap
2. Release Curvature and Attachments

5. Prepare Island Flap for Urethra Formation

1. Take Measurements
2. Place Stay Sutures
3. Mark Incision
4. Incision
5. Dissection

6. Construction of Penile Urethra

1. Insert and Inflate Foley Catheter
2. Suture Flap Around Catheter to Build Urethra

7. Mobilize Native Urethra for Length

8. Excise Native Urethral Orifice

9. Anastomosis of Native and Constructed Urethral Segments

10. Alignment and Attachment of New Urethral Orifice

1. Place Stay Sutures in Glans
2. Incision
3. Suture New Urethral Orifice into Glans Incision
4. Suture Glans Penis Around Urethra

11. Suture Corpus Around Penile Urethra

12. Skin Closure

1. Scrotum
2. Split Island Flap
3. Dorsal Attachment
4. Ventral Shaft
5. Distal Shaft
6. Tie Catheter and Cut Sutures

13. Post-op Remarks